Showing papers by "Anders H. Riis published in 2008"
TL;DR: Type 1 and type 2 diabetes are risk factors for a pneumonia-related hospitalization and poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization with pneumonia.
Abstract: OBJECTIVE —To examine whether diabetes is a risk factor for hospitalization with pneumonia and to assess the impact of A1C level on such risk. RESEARCH DESIGN AND METHODS —In this population-based, case-control study we identified patients with a first-time pneumonia-related hospitalization between 1997 and 2005, using health care databases in northern Denmark. For each case, 10 sex- and age-matched population control subjects were selected from Denmark9s Civil Registration System. We used conditional logistic regression to compute relative risk (RR) for pneumonia-related hospitalization among subjects with and without diabetes, controlling for potential confounding factors. RESULTS —The study included 34,239 patients with a pneumonia-related hospitalization and 342,390 population control subjects. The adjusted RR for pneumonia-related hospitalization among subjects with diabetes was 1.26 (95% CI 1.21–1.31) compared with nondiabetic individuals. The adjusted RR was 4.43 (3.40–5.77) for subjects with type 1 diabetes and 1.23 (1.19–1.28) for subjects with type 2 diabetes. Diabetes duration ≥10 years increased the risk of a pneumonia-related hospitalization (1.37 [1.28–1.47]). Compared with subjects without diabetes, the adjusted RR was 1.22 (1.14–1.30) for diabetic subjects whose A1C level was CONCLUSIONS —Type 1 and type 2 diabetes are risk factors for a pneumonia-related hospitalization. Poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization with pneumonia.
260 citations
TL;DR: The use of statin use is associated with decreased mortality after hospitalization with pneumonia, and ex-use of statins and current use of other prophylactic cardiovascular drugs were not associated with decreases mortality from pneumonia.
Abstract: Background While some experimental and clinical research suggests that statins improve outcomes after severe infections, the evidence for pneumonia is conflicting. We examined whether preadmission statin use decreased risk of death, bacteremia, and pulmonary complications after pneumonia. Methods We conducted a population-based cohort study of 29 900 adults hospitalized with pneumonia for the first time between January 1, 1997, and December 31, 2004 in northern Denmark. Data on statin and other medication use, comorbidities, socioeconomic markers, laboratory findings, bacteremia, pulmonary complications, and death were obtained from medical databases. We used regression analyses to compute adjusted mortality rate ratios within 90 days and relative risks of bacteremia and pulmonary complications after hospitalization in both statin users and nonusers. Results Of patients with pneumonia, 1371 (4.6%) were current statin users. Mortality among statin users was lower than among nonusers: 10.3% vs 15.7% after 30 days and 16.8% vs 22.4% after 90 days, corresponding to adjusted 30- and 90-day mortality rate ratios of 0.69 (95% confidence interval, 0.58-0.82) and 0.75 (0.65-0.86). Decreased mortality associated with statin use remained robust in various subanalyses and in a supplementary analysis using propensity score matching. In contrast, former use of statins and current use of other prophylactic cardiovascular drugs were not associated with decreased mortality from pneumonia. In statin users, adjusted relative risk for bacteremia was 1.07 (95% confidence interval, 0.69-1.67) and for pulmonary complications was 0.69 (0.42-1.14). Conclusion The use of statins is associated with decreased mortality after hospitalization with pneumonia.
177 citations
TL;DR: Assessment of 30‐day mortality from bacteremia in relation to age and comorbidity and the association between age and mortality with increasing comorrbidity finds no clear relationship with age or age-related mortality.
Abstract: OBJECTIVES: To assess 30-day mortality from bacteremia in relation to age and comorbidity and the association between age and mortality with increasing comorbidity.
DESIGN: Population-based cohort study.
SETTING: North Jutland County, Denmark.
PARTICIPANTS: Adults in medical wards with community-acquired bacteremia, 1995 to 2004.
MEASUREMENTS: Smoothed mortality curves and computed mortality rate ratios (MRRs) using Cox regression analysis.
RESULTS: Two thousand eight hundred fifty-one patients, 851 aged 15 to 64, 1,092 aged 65 to 79, and 909 aged 80 and older were included. Mortality increased linearly with age. Compared with patients younger than 65, adjusted MRRs in patients aged 65 to 79 and 80 and older were 1.5 (95% confidence interval (CI)=1.2–2.0) and 1.8 (95% CI=1.4–2.3), respectively. Mortality also increased with level of comorbidity. Compared with patients with low comorbidity, adjusted MRRs in patients with medium and high comorbidity were 1.5 (95% CI=1.2–1.8) and 1.7 (95% CI=1.4–2.2), respectively. Regardless of the level of comorbidity, MRRs were consistently higher in older than in younger patients.
CONCLUSION: Older age and greater comorbidity predicted mortality, and increasing age-related comorbidity did not explain the effect of age.
65 citations
TL;DR: History and severity of heart failure are associated with a poor outcome for patients hospitalized with pneumonia, and pre-existing heart valve disease and atrial fibrillation substantially increased mortality.
Abstract: Background
There are limited data describing how pre-existing heart failure affects mortality following pneumonia.
49 citations
TL;DR: Mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users is examined to increase mortality at a level comparable to NSAIDs.
Abstract: Aim
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown. The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users.
27 citations
TL;DR: COPD substantially increased 30-day mortality among patients with bleeding and perforated peptic ulcers and the use of oral glucocorticoids among COPD patients was associated with higher MRRs for both perforation and bleeding peptic Ulcer patients.
22 citations
TL;DR: This data indicates that the use of antipsychotic drug use afterptic ulcer perforation is a serious surgical emergency with a substantial short‐term mortality, but the influence of antip psychiatric drug use on the prognosis remains unknown.
Abstract: SUMMARY Background Peptic ulcer perforation is a serious surgical emergency with a substantial short-term mortality, but the influence of antipsychotic drug use on the prognosis remains unknown. Aim To examine the association between antipsychotic drug use and 30-day mortality following peptic ulcer perforation. Methods This cohort study comprised 2033 patients with a first-time hospitalization with peptic ulcer perforation, in Northern Denmark, between 1991 and 2004. Data on preadmission use of antipsychotics and other medications, psychiatric disease, other comorbidities and mortality were obtained through population-based medical databases. We used Cox regression analyses to compute adjusted mortality rate ratios (MRRs). Results One hundred and sixteen (5.7%) patients with peptic ulcer perforation were current users of antipsychotic drugs at the time of hospital admission and 205 (10.1%) were former users. The overall 30-day mortality was 27%. Among current users of antipsychotics 30-day mortality was 39%. The adjusted 30-day MRR for current users of antipsychotic drugs compared with non-users was 1.7 (95% CI: 1.2‐2.3). Former use was not a predictor of mortality. The increase in mortality was equal in users of conventional and atypical antipsychotics. Conclusion Use of antipsychotic drugs is associated with substantially increased mortality following peptic ulcer perforation.
11 citations
1 citations